The Healthy Minds, Healthy Students Project is a three-year collaborative project with the goal to improve the pediatric mental health care delivery system in West Virginia by increasing, enhancing, and improving mental health services in our public schools.
According to the CDC, nearly 1 in 5 children have a mental, emotional, or behavioral disorder. Only about 20 percent of children receive care from a specialized mental health care provider. Lack of access to proper mental health care services for kids is a national problem, with growing prevalence and mounting public concern.
West Virginians have historically struggled to access effective health care– 52 of our 55 counties are designated as Medically Underserved Areas/Populations by the Health Resources and Services Administration (HRSA). While we can’t list or map specific areas lacking mental health care services for kids– as this information isn’t collected and disseminated– we know that the U.S. Department of Justice recently reached an agreement with the State of West Virginia to resolve its 2015 conclusion that the State violates the Americans with Disabilities Act (ADA) by unnecessarily institutionalizing children with serious emotional or behavioral disorders in residential treatment facilities instead of providing them in-home and community-based mental health services. When the USDOJ first sent its letter to Governor Tomblin, our state was experiencing the first effects of the opioid crisis on its children.
According to our State Department of Health and Human Resources (WVDHHR), between 2014 and 2017, our state saw a 46 percent increase of children in state custody, a 22 percent increase in abuse/neglect referrals and a 34 percent increase in open CPS cases over 3 years. We remain number one in the country for child removals.
WVDHHR has deemed this a “child welfare crisis,” and it has disproportionately affected areas with lower economic opportunities—places also often medically underserved. While many communities across our state have scrambled to respond to the needs of its children, our systems have been slow to respond.
Currently, we have no state strategic plan to address the health care needs of affected children. We have no state map or list of pediatric mental health care providers– where they are located, services provided, etc. We have no comprehensive list or map of services provided in schools– neither preventive or medica– and we have no state standards for what a school-based mental health program should look like.
Many schools around the state are trying their best to address the needs of their students, but no system or organization is documenting their efforts, elevating best practices, evaluating the efficacy of services, or addressing the root causes that have put our kids in crisis—poverty, addiction, stigma, and trauma.
Mental Health Care and WV Schools:
In early 2019, the West Virginia State Dept of Education (WVDE) held eight public forums around the state. WVDE officials reported 1,630 people attended.
In its final report from these public forums, WVDE found increasing teachers’ compensation, more wraparound services, incentives and addressing the math teacher shortage were among the top priorities. From their compiled report: “Forum attendees overwhelmingly recognized a need for greater social emotional supports for students. Additionally, the need to take significant action to address the heightened social emotional issues facing students in West Virginia was expressed due to the effects of increased drug use, including the opioid crisis.”
The Political Landscape:
WV Governor Jim Justice signed HB 206– “The Education Bill”—on June 28, 2019. One of the few areas of agreement between legislative Republicans and Democrats on education reform included wraparound services for students with emotional or developmental needs. HB 206 includes more than $30 million for putting more mental health professionals — counselors, psychologists, and nurses — in schools. The funding allows for five mental health professionals per every 1,000 students. The bill also requires counselors to spend 80 percent of their time on direct counseling — up from 75 percent previously.
Indeed, there is bipartisan support for more mental health care in our schools. While $30 million for more health service staff is a great step in the right direction, it isn’t comprehensive and potentially unsustainable.
The end goal of The Healthy Minds, Healthy Students Project is to ensure that all of West Virginia’s students have access to comprehensive mental health care–from researched-based prevention and wellness promotion to the full continuum of mental health care– in their schools and communities.
For this first year of the project, we intend to assess the landscape of mental health services available in West Virginia’s public schools and share our findings via a public dissemination strategy that both utilizes data visualization and narrative approaches.
Currently, we have no comprehensive picture on how schools and communities are addressing the mental health care needs of their students. Before you can solve a problem, you first have to understand it. And so, an important first step is to understand the basics of what programs, staffing and services are provided in each of West Virginia’s 680 public schools.
As we collect this data, we intend to launch an interactive web and social media sites that document the project as it unfolds. We plan to highlight great projects, meet community champions, discuss the complex issues that are driving the need for more mental health services in our communities, and address the systemic challenges that we must overcome in order to change our health care and public education systems to meet the needs of our students.
Most of all, we want to create a statewide network of champions who will push meaningful change forward, for the sake of kids who need services but currently can’t find them.
Our first-year outcomes will include a first-ever comprehensive mapping of mental health services in our schools as well as a public relations and awareness strategy to address the complex challenges to providing mental health care to children and adolescents in our state.
The Healthy Minds, Healthy Students Project will address this need for a strategic plan of action in two ways: assess the programs and services provided in our public schools and share the information as we gather it, providing an online platform for collaborative partners, providers, schools, and students the opportunity to share their stories, challenges, and ideas for policy reform.
Our Executive Director, Kelli Caseman, has worked extensively with schools and school-based health centers for over 10 years. She is a current fellow in the Robert Wood Johnson Foundation’s Interdisciplinary Research Leaders Program, working as part of a state cohort on the project “Improving Health among Youth in Rural Appalachia: Enhancing School-Based Health Centers.” She has been a member of the West Virginia Expanded School Mental Health Steering Team since 2011, and currently oversees West Virginians for Affordable Health Care’s Children’s Health Collaborative Project—a grassroots initiative to cultivate community support for connecting schools to health care services. Together with founding members of Think Kids, the team will cultivate relationships with partners on both the local and state levels, knowing that these relationships are key to collecting meaningful data and building capacity for change.
Our project will publicly launch on January 1, 2020. At that time, we will begin distributing brief surveys through the Qualtrics program. Currently, there are 680 public schools in 55 counties, with approximately 270,613 students. To ensure participation from every county and school, we will hire a full-time coordinator. Interns will upload data and maintain the web and social media sites. Kelli will focus on capacity building by conducting site visits, recruiting partners, raising public awareness, and garnering additional funding for the second phase of the project.
In the fall of 2020, we will initiate phase two of the project, where we will begin assembling partners to draft a strategic plan. At the end of 2021, we anticipate the adoption and dissemination of a strategic plan in time for the 2022 legislative session.